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Medicare fee schedule by locality · Q3 2026 release

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Massachusetts

Massachusetts has 2 Medicare payment localities, each with its own GPCIs — the work GPCI alone ranges from 1.016 to 1.041 across the state. National amounts use GPCI 1.000. Every row below shows what a common code pays once each locality's real GPCIs apply.

Localities in Massachusetts

99213 non-facility amount by locality, Q3 2026 (before sequestration) — national baseline $95.19.

Locality Work GPCI PE GPCI MP GPCI 99213 amount
Metropolitan Boston 1.041 1.194 0.890 $106.10 (+11.5%)
Rest of Massachusetts 1.016 1.053 0.797 $97.86 (+2.8%)

Need a different code or the facility rate? Use the rate calculator with any locality above selected.

Common questions

How many Medicare payment localities are in Massachusetts?

Massachusetts has 2 Medicare payment localities, each with its own work, practice-expense, and malpractice GPCIs.

Do Medicare rates vary within Massachusetts?

Yes. Massachusetts's 2 localities have different GPCIs — the work GPCI alone ranges from 1.016 to 1.041. The same code can therefore pay a different amount depending on where in the state it's billed.

Source & method

GPCIs and example rates computed from the CMS Medicare Physician Fee Schedule Q3 2026 release. Example amounts take the national non-facility figures and rescale them by each locality's GPCIs, before the ~2% sequestration cut. Releases are immutable: a rate retrieved for a past quarter always reflects that release.

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